key: cord-258881-74aijckl
authors: Wang, Maomao; Luo, Limin; Bu, Haiji; Xia, Hu
title: Case Report: One Case of Coronavirus Desease 2019(COVID-19) in Patient Co-nfected by HIV With a Low CD4+ T Cell Count
date: 2020-04-23
journal: Int J Infect Dis
DOI: 10.1016/j.ijid.2020.04.060
sha: 
doc_id: 258881
cord_uid: 74aijckl

Abstract The ongoing outbreak of COVID-19 that began in Wuhan, China has become an emergency of international concern When thousands of peolple were infected around the world.We report a case infected by SARS-Cov-2 and HIV simultaneously,which showed a longer course of disease and slower generation of specific antibody. This case highlights the coinfection of SARS-Cov-2 and HIV may impaire the immune system worse.

Since December 2019, an outbreak of coronavirus disease, officially named by the World Health Organization as COVID-19, appeared in pneumonia and respiratory illness. Lymphopenia has been considered as a poor prognostic factor for severe acute respiratory syndrome(SARS) [1] as well as in COVID-19 [2] . Here, we report clinical findings in a patient confirmed with COVID-19, who was also co-infected by Human immunodeficiency virus (HIV) .

Here we report a patient infected by SARS-Cov-2 , who had a relatively long course of disease with unstable state. Then eight markers of infectious diseases was checked and the result showed that abtibodies to HIV and syphilis were positive .Then the patient was transferred to specialty hospital for further treatment on March 8. In the specialty hospital, the CD4 cell count was 34/ul, CD8 cell count was 737/ul and CD4/CD8 was 0.05. The dectection of cryptococcus antigen in serum was negative and The patient was then given anti-HIV treatment .

On February 11, 2020, a 37-year-old man was presented to Wuhan Huo Shen Shan hoapital, with a history of fever, dry cough and chest pain since January 10, 2020. The chest CT of this patient on COVID-19 is caused by a novel type of coronavirus SARS-Cov-2.

People are generally susceptible to SARS-Cov-2 infection, especially the elderly patients and those with underlying diseases [2] . The median time from onset of symptoms to first hospital admission was 7 days, to shortness of breath was 8 days, to ARDS was 9days, to mechanical ventilation was 10.5 days, and to ICU admission was 10.5 days. [3] The patient described here were admitted to our hospital because of fever which lasting nearly one month and typical changes of viral pneumonia in lung CT imaging. The prominent complaint was dyspnea, The study of Qin showed, The total number of B cells, T cells, and NK cells significantly decreased in patients with COVID-19, and more evident in the severe cases compared to the non-severe group. The author suggested that SARS-Cov-2 might damage lymphocytes, especially T lymphocytes, and the immune system was impaired during the period of disease [2] . corticosteroids may delay viral clearance [3] . In this case, corticosteroid therapy was used( methylprednisone 200mg totally) accompanied with arbidol for anti-virus therapy.The body temperature turned normal. we also used Tocilizumab one time to fight inflammation storm, which did not show the reduction of IL-6 in serum.

In conclusion, we report the clinical features of a patient infected by SARS-Cov-2 and HIV. The case appeared to be a long course of disease for more than 2 months. And until the later period of the course the IgM in serum could be detected, which may due to the destroy of the immune response by the two viruses cooperatively. 

The epidemiology of severe acute respiratory syndrome in the 2003 Hong Kong epidemic:an analysis of all 1755 patients

Dysregulation of immune response in patients with COVID-19 in Wuhan

We declare that we have no financial and personal relationships with other people or organizations that can inappropriately influence our work, there is no professional or other personal interest of any nature or kind in any product, service and/or company that could be construed as influencing the position presented in, or the review of, the manuscript entitled. 
